Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.19 / $85.19 / $85.19	Facility		$85.19	$85.19	$85.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $92.91 / $118.20	Professional		$82.40	$92.91	$118.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.72 / $161.40 / $267.05	Facility		$146.72	$161.40	$267.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.05 / $136.46 / $180.47	Professional		$132.05	$136.46	$180.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.56 / $314.00 / $314.00	Facility		$105.56	$314.00	$314.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.15 / $394.69 / $613.01	Facility		$88.15	$394.69	$613.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.93 / $216.22 / $277.70	Professional		$74.93	$216.22	$277.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.18 / $122.90 / $168.74	Facility		$40.18	$122.90	$168.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $84.02 / $146.72 / $176.08	Professional		$84.02	$146.72	$176.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.42 / $153.34 / $689.27	Facility		$71.42	$153.34	$689.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $74.02 / $170.15	Professional		$62.23	$74.02	$170.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $69.94 / $116.57	Professional		$50.00	$69.94	$116.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.18 / $127.79 / $168.74	Facility		$40.18	$127.79	$168.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $84.02 / $146.72 / $176.08	Professional		$84.02	$146.72	$176.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $225.82 / $373.38	Professional		$146.72	$225.82	$373.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.15 / $286.58 / $689.27	Facility		$88.15	$286.58	$689.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.93 / $88.15 / $730.72	Professional		$74.93	$88.15	$730.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $146.72 / $146.72	Professional		$146.72	$146.72	$146.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $146.72 / $146.72	Professional		$146.72	$146.72	$146.72
United Facility/Professional Facility Modifier Low / Median / High Price $49.35 / $65.55 / $93.41	Facility		$49.35	$65.55	$93.41
United Facility/Professional Professional Modifier Low / Median / High Price $48.80 / $73.20 / $140.31	Professional		$48.80	$73.20	$140.31